Tips for clinicals (today was my first day and overwhelmed)

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I have been in school a few months. We had "lab" for skills but it wasnt the greatest and we just did everything one time. I didnt even get apical or lung sound practice (kind of disorganized then at the end sometimes would make us rush). We are done with lab now and our first clinical day with patients was today. Im hoping it gets better, but I just felt akward and unsure of what I was supossed to be doing and when. My patient was older and had dementia etc. When we arrived they were already starting breakfast. I fed my patient and then took him back to his room and did vitals the best I could despite having little practice and the clothing being in the way. I believe he has to wear long sleeves. Anyways after that I put him in the hallway sitting in the wheelchair. I asked a worker and they told me to. Then he pretty much slept. I just felt akward (I normally have anxiety),not knowing what to say to the patient while he was awake (and the fact hes not really verbal etc.) So what do you do (I could try to ask my teacher) when it says incontinent care q2-3h or prn and the patient is sleeping or not able to communicate. A nurse told me they pretty much stay up when they are taken out of bed. I guess next time my teacher is going to try to have us get them out of bed. I have no experience at all with patient contact. Its just not knowing a routine and being brand new its overwhelming. Any suggestions or tips to help me succeed and also to get as much of a routine down and time management skills THANKS! Im book smart but hands on things I tend to learn slower. My anxiety doesnt help.

Do not be too hard on yourself. I felt the same way during the first few days of clinical. I've never worked with patients or had any contact either. Knowing the skill was not my problem it was the idea that I was new in the environment and did not know how to act in such a space. Infact the first 10 minutes of my first day on my first clinical i cried. Yup I cried because In the facility we were in they had a vent unit and my teacher was saying how everyone had to be the best and perform the best in order to be there. That made me feel horrible because i did not have the self confidence in performing the best. Once i spoke my mind and admitted i wasnt confortable she said we would go on the rehab floor. I felt horrible becuase everyone seemed like they wanted the vent unit. As the five days on the rehab floor went on i was doing great. I got my review did my careplan and it was perfect. Next rotation we went to the vent unit. It was a amazing experiance and i loved it i learned so much and i performed exceptionally. Just remember not to sell yourself short. Do things at your pace and let the teacher know when you are questioning your own ability to do something. I never thought i would be able to set an example for others. My teacher said the best thing she loved about me was that i questioned everything and was always there to keep busy. The ackward weird feeling will lessen the further you get into it!!! I loved clinicals even though i thought i was going to hate them and crash and burn!!!! Your your own worst enemy!!! Self confidence is where its at!!! GoodLuck!!!!!

Hi cmm4ever,well, what you did is already a good job! I think almost everyone who had experienced their clinical exposure for the first time felt the same, so what you feel is just normal. Not everything can be learned inside the classroom so you have to be very observant and don't hesitate to ask questions, I'm sure there will always be someone who is willing to answer your inquiries.

I was the same way when I did my first day and that was yesterday. Well it was the first day we got our patients. We actually started last week, but we did two days of orientation so that does not really count and then this week we were only there one day. Same in the lab I was in. Not enough practice time and working with plastic mannequins does not help either. Trying to do blood pressure in a lab when you are rushed is not the same as doing it on a patient. And listening to heart rates is confusing because in lab we did it once and even then it was rushed. Everything was rushed and now they want you to tell them what you heard and it is scary because I am still learning what I am supposed to hear in the first place. Ugh!
So I know how your feel. Also the instructor was more harsher than what was presented in the labs. So I need to be careful which makes my anxiety go up even more. I get nervous too so when I talk or ask a question I will ask the same question numerous times which makes people think I am an idiot and it's just my anxiety is through the roof which makes it difficult for me to hear. It gets so bad that I will only hear a mumble. It is nerve racking because I have no backround in this and most of my group does. I just feel lost too. So I totally get where you are coming from.

All I am going to do is breathe slowly, take my time with everything and think everything through.

First clinicals are usually awkward. Do you have partners assigned to you? This is what usually helps me. I deal with a lot of anxiety too, btw. After you do what you are supposed to with your patient/resident, help your partner or classmate. Ask your clinical instructor what else you could/should be doing to keep yourself busy. Not only does it make the time go by faster, you get more experience, and get yourself a good reputation as well. Good luck!

My first day of clinical I was the only one in my group that was not a CNA or had no care-giving experience. It DOES get better with practice. The first day I felt so weird being there because I was so new and didn't know what to do, I felt more in the way than anything. We just finished the LTC clinicals and on Feb 1st we start in the hospital. Just yesterday at our last day in the nursing home, I did the bed bath for my rd by myself, and got her dressed/did her treatments (just creams she had to her buttocks and toes) and did a head to toe assessment. The only thing I asked for help for, was she used a sit to stand, and was 2+ assist. And this lady was not light, plus whenever I rolled her towards me to pull something under her or whatever, she was still asleep. I kept watching her respiratory rate because I couldn't believe she was still asleep. She did not wake up through my entire assessment (which included me listening to her lungs, heart, palpating and percussion among other things) until we lifted her to a sitting position so we could get her on the lift to her wheelchair. And my instructor said my assessment was great! You will learn, and they will teach you what you need to know.

I learned on mannequins and had no idea when I got to clinical what to do. But you learn. If you have any questions, ask the nurses, or your instructor. They would rather you be safe then anything else. AND it shows initiative on your part :]

What you are feeling is totally normal and we've all been there, grown from it, as will you. My first semester my clinical instructor basically just threw us to the wolves. Assigned our patients, checked our preplanning sheet and sent us out onto the floor. Just remember it is a learning experience. No one has ever just walked into a hospital and became a nurse without going through this. If this is your first clincial I'm assuming this is your first semester? Lung sounds are really hard to differentiate, and apical sounds are even more difficult. Focus on the technique...like where to place your stethoscope, landmarks etc. Patients are usually very forgiving with student nurses. Hang in there...it will come to you. Best of luck

Best advice? Get there early and tell yourself that you are about to go in and add a little comfort to someone's life. Students offer something to patients that staff sometimes (and usually) cannot give- time. Remember that? Also, ask questions of your class mates and instructor first before going to the nurse. Make sure you know what you need. You will do great!!